“We Cannot Let Them Die”: Undocumented Immigrants and Media Framing of Health Deservingness in the United States
Qualitative Health Research
Abstract and Figures
Based on a systematic qualitative analysis of articles published by The New York Times (2009–2017), this article presents the main media frames that support the access to government-sponsored health care by undocumented immigrants, just before and after passage of the U.S. Affordable Care Act in 2010. Under the umbrella of “selective inclusion,” this study highlights a “compassionate frame” that conveys sympathy toward severely ill, undocumented immigrants. This approach is reinforced by a “cost-control” frame that underlines the economic benefits of providing health care to the undocumented immigrant population in the United States. Supported by both humane and market-based approaches, these frames make a compelling case for the inclusion of particular groups into the U.S. health care safety net. Ultimately, these findings contribute to our understanding of the media framing of undocumented immigrants’ right to health care on the basis of deservingness.
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... Although the right to health is recognized by the World Health Organization (4) as one of the most fundamental rights of every human being, im/migrants encounter particular barriers in accessing health services and attaining adequate health states. In the U.S., irregular im/migrants are not eligible for any federally funded public health insurance programs (5). Although the Patient Protection and Affordable Care Act (ACA) was passed in 2010 with the goal of providing affordable and accessible care to the uninsured population of the U.S., the ACA prevents all undocumented im/migrants from accessing any government-based medical care (5). ...
... In the U.S., irregular im/migrants are not eligible for any federally funded public health insurance programs (5). Although the Patient Protection and Affordable Care Act (ACA) was passed in 2010 with the goal of providing affordable and accessible care to the uninsured population of the U.S., the ACA prevents all undocumented im/migrants from accessing any government-based medical care (5). ...
... They also have an increased likelihood of confronting both tangible and intangible barriers to accessing healthcare (12). This can be witnessed through their tendency to occupy the most dangerous, dirty and demeaning jobs characterized by exploitation and precarity (5,12). Scholars have shown that irregular im/migrants are often discriminated against, not paid for their labour, overworked, underpaid or mistreated at work (13). ...
Although the right to health is recognized by the World Health Organization as one of the most fundamental rights of every human being, migrants encounter particular barriers in accessing health services and attaining adequate health states. There exists an interconnection between access to healthcare and precarious migrant statuses that put migrants at risk of being deported when seeking medical treatment. Medical deportation—also called medical repatriation—refers to the extralegal practice of forcibly removing immigrant and migrant patients to their country of origin to avoid the burden of costly hospital care. This analytical essay will investigate the logics and mechanisms behind medical deportation in the United States which facilitate the state’s production of sovereignty through the control and surveillance of migratory populations. This knowledge will be utilized to understand the barriers faced by irregular im/ migrant populations in seeking medical care and the implications of transnational labour migration and medical deportation on migrant health. Not only do irregular im/migrants face the risk of deportation when seeking medical care, shaping their health-seeking behaviours, but they are also commonly positioned in undesirable work situations that heighten their vulnerability to health risks. Moreover, the act of medical deportation neglects to consider an im/migrant’s ability to access adequate healthcare within their ‘home’ country, further placing im/migrants in precarious health circumstances.
... In addition, destinations that are perceived as hotspots for illegal migration may suffer a loss of reputation. Incidents related to illegal migration are often reported in the media (Farris and Silber Mohamed, 2018), which can result in the destination being perceived as unsafe or hostile to tourists (Viladrich, 2019;Wright et al., 2021). Such negative publicity can damage the image of the destination in the long term and reduce tourists' interest in visiting. ...
... Nadalje, destinacije koje se percipiraju kao žarišta nezakonitih migracija mogu doživjeti pad ugleda. Mediji često izvještavaju o incidentima povezanima s nezakonitim migracijama (Farris i Silber Mohamed, 2018), što može stvoriti negativnu percepciju destinacije kao nesigurne ili neprijateljske prema turistima (Viladrich, 2019;Wright i dr., 2021). Takav negativni publicitet može dugoročno naštetiti imidžu destinacije i smanjiti interes turista za posjetom. ...
Migration is a phenomenon that has been occurring since prehistoric times in which people change their permanent place of residence. In the modern era, when a migrant cross an international border during migration, it is called international migration. International migration can be legal or illegal. Illegal migration has affected various areas of life in Croatia over the last decade, including tourism. Although the public reaction to migrants during the migrant crisis in 2015 was mostly positive, later research has shown that illegal migrants still cause fear and a sense of insecurity among the population to a certain extent. To explore the impact of illegal migration on tourism, a survey was conducted among 60 representatives of the tourist boards of cities and municipalities from seven counties where the highest number of illegal border crossings was recorded. The research found that illegal migration has a negative impact on the perception of the security of tourists and local communities in border areas, which can lead to a weakening of tourism activities and confidence in the destination. Furthermore, it was found that there has been no decrease in tourism traffic to date, but also that the tourism sector in border areas is not trying to strengthen destinations’ resistance to illegal migration. In order to prevent the negative impact of illegal migration on tourism in the future, measures such as diversifying the tourism offer, improving security measures and intensifying cooperation between the tourism sector and local authorities should be taken.
... How news media frame healthcare events and information can influence patients' perceptions, physician behaviour (Diedrich and Dockweiler, 2021), and even policy-makers' and health-care professionals' awareness of health-related issues, with the potential to affect regulation, litigation, and research and development (Maniatopoulos et al., 2019). Ultimately, news media structure the delivery of healthcare information, which may influence the public's feelings and actions regarding their own health (Maniatopoulos et al., 2019), or the delivery of healthcare to others (Viladrich, 2019). The public can then call for political and systemic changes should there be strong enough uptake of a particular opinion of a health-related issue. ...
... We elected to use this method mix over an entirely manual content analysis due to the size of our corpus, which includes 1,198 news articles. Upon a review of health-related news studies, we found that manual coding methods were typically used to examine corpora under 400 articles (Ogbogu and Hardcastle, 2021;Viladrich, 2019;Maniatopoulos et al., 2018;Diedrich and Dockweiler, 2021;Collins et al., 2006). For analysis related to each of our research questions, we created subsets out of our telehealth dataset, made up of articles pre-or post-onset of COVID-19 (based on publication date), grouped by country (based on publication location), and grouped by journalism style (whether explanatory or traditional). ...
... Using big data to continuously reinforce toxic discourses is problematic in both its logic of responsibility and respect for human personhood, which belong to the core of the religious and philosophical heritage. Access to healthcare for undocumented immigrants is addressed by Viladrich where structural violence underlying media narration is in focus (Viladrich, 2019). This generates immense ethical tensions, especially using distinctly Christian ethics where the weak and vulnerable should be promoted justly in health systems. ...
This research explores how conservative and liberal U.S. media reported on Japanese immigration during the 2019-2024 immigration policy shifts and the impact on public perception. From a religious and ethical perspective, the research focuses on the media's ethical obligation to report truthfully on immigrants and to do so with fairness, justice, and compassion, arguments undergirded by solidarity, dignity, and the treatment of the stranger that most religious traditions articulate. The study design uses both content analysis of article frequency analysis and thematic analysis to examine how media framing influences discourse. The results suggest that, in conservative sources, immigration was framed noticeably negatively, while, at the same time, they and the liberal ones placed a lot of emphasis on the themes of history and community. These issues may sound more like the culture, and religion's messages on continuity and togetherness of people with similar moral principles irrespective of their ideological positions. The findings further supported by Chi-square tests suggest that media has become less polarized which is evidenced by the fact that their tones and thematic concerns are now rather similar. All the recommendations made in the study call for increased and more informative news and current affairs reporting, guided by ethical norms regardless of the meaning of the given society, which will enhance social cohesion. Subsequent research should incorporate increased sample sizes and diverse subjects as well as use cross-sectional research to understand media framing's effects on the immigration debate with an emphasis placed on the moral principles evident in religious and philosophic principles.
... Perceptions of the immigrant's socially construction 'deservingness' may be a primary driver for whether people believe they should have access to health care (Schneider andIngram, 1997, 2005;Viladrich, 2019). Generally, people express very little support for providing health care coverage to undocumented immigrants (Sanchez et al., 2011), though there are higher levels of support for providing coverage to children of undocumented parents (Sanchez and Sanchez-Youngman, 2013). ...
Legal status is an important social determinant of health. Immigration enforcement policies may be an important contributor to health disparities in the form of interior border checkpoints (IBCs). These checkpoints may prevent immigrants and their families from seeking needed medical care. Currently, we do not know how these barriers are perceived by the public. We administered a survey of 6,178 respondents from 13 November to 19 November of 2023 that contained a survey experiment to assess public attitudes on the issue. Respondents were generally not supportive of detaining individuals at IBCs or medical facilities for emergencies regardless of characteristics of the care-seeking individual. A majority was supportive of detention when medical treatment was complete. Respondents were generally more sympathetic towards children and pregnant women. Partisanship and sympathy expressed towards immigrants influenced attitudes towards detention. Findings based on race and ethnicity showed inconsistencies. A majority of Americans did not believe that IBCs should impede undocumented immigrants from accessing medical care, especially in emergency situations and for children and pregnant women. Our findings indicate that there is broad public support for expanding existing policies to allow for undocumented individuals to pass through IBCs to access medical care.
Disparities across social, economic, educational, and environmental realms of health significantly impact illness outcomes, and is highly relevant to infections of the nervous system. Neglected tropical diseases, neurological effects of HIV and syphilis, and emerging pathogens impact vulnerable populations differentially. These disparities are the result of current, evolving, and historical systemic inequities that contribute to the preventable differences in healthcare access and care often experienced by vulnerable communities. In this chapter we highlight clinical cases in which each patient’s care of neurological infections was significantly affected by healthcare inequities. The profound influence of social determinants of health outlined in each of these cases emphasizes the continued to need to identify and address systematic and structural barriers that hinder the possibility of optimal health for all members of our global society.
Drawing on content analysis of 517 New York Times news reports published between 1995 and 2016, the author examines the institutionalization of opioid responses in terms of changing media framing of opioid use. The findings indicate that news frames were situated between the lenses of medicalization and decriminalization. Modes of penal social control shifted as early as the 1990s because of budgetary concerns. Drug reform efforts pushed law enforcement agencies to criminalize doctors and big pharma. Consequently, medical professionals and social activists advocated for new cultural frameworks about opioid use. However, the expansion of medical concepts alone did not medicalize opioid use, as evidenced by persistent news frames opposing opioid maintenance treatments. Instead, medicalization materialized as part of the public health solution when law enforcement agencies adopted new modes of medical social control. This article illustrates the making of a new penal-medical nexus regulating drug use.
This article explores the homecoming experiences of international health care workers who responded to the 2014 to 2016 West African Ebola outbreak. Interviews with 11 frontline international medical staff were undertaken and data thematically analyzed. It was found that international health care workers faced an unforeseen risk of stigmatization upon their return home, related to others’ fears of their infectious status. Media representations of the disease appear to have played a significant role in heightening societal perceptions of the risks associated with the returning health care workers, resulting in public hostility toward them. For participants, these social risks overtook concerns about biological risks during the immediate postmission period. The participants developed different strategies to cope with courtesy stigma, by rationalizing stigmatizing attitudes, educating people, or simply through an avoidance of others.
Most writing on sociological method has been concerned with how accurate facts can be obtained and how theory can thereby be more rigorously tested. In The Discovery of Grounded Theory, Barney Glaser and Anselm Strauss address the equally Important enterprise of how the discovery of theory from data-systematically obtained and analyzed in social research-can be furthered. The discovery of theory from data-grounded theory-is a major task confronting sociology, for such a theory fits empirical situations, and is understandable to sociologists and laymen alike. Most important, it provides relevant predictions, explanations, interpretations, and applications. In Part I of the book, "Generation Theory by Comparative Analysis," the authors present a strategy whereby sociologists can facilitate the discovery of grounded theory, both substantive and formal. This strategy involves the systematic choice and study of several comparison groups. In Part II, The Flexible Use of Data," the generation of theory from qualitative, especially documentary, and quantitative data Is considered. In Part III, "Implications of Grounded Theory," Glaser and Strauss examine the credibility of grounded theory. The Discovery of Grounded Theory is directed toward improving social scientists' capacity for generating theory that will be relevant to their research. While aimed primarily at sociologists, it will be useful to anyone Interested In studying social phenomena-political, educational, economic, industrial- especially If their studies are based on qualitative data. © 1999 by Barney G. Glaser and Frances Strauss. All rights reserved.
Since the mid-1980s, welfare state arrangements have become increasingly conditional and austere. Simultaneously, deservingness perceptions have become increasingly important. This paper examines preferences as to which social categories contemporary welfare state reforms should target. Using unique data from a 2006 Dutch survey, the results reveal that the Dutch discern two principles of welfare state reforms – the first tapping into distributive reforms – decreasing redistribution, the latter tapping into commodifying reforms – increasing recommodification. Moreover, the level of people's identification with social categories explains why the public prefers commodifying reform to be intensively targeted at some social categories, but not at others.
This article examines the effects of two forces in the context of reception: the legal regime and enforcement practices and media portrayals of immigrants as they combine to shape the lives of immigrants, particularly Latinos, directly and indirectly. It focuses on the case of Latino immigrants living in Phoenix, Arizona. Although the context of reception is conceptualized as including laws and policies, the media contributes significantly, as media portrayals reinforce or fuel the effects of laws and policies. When laws are exclusionary and enforcement is expanded, negative media portrayals contribute to create a particularly hostile context at the level of formal institutions and at the level of public discourse. Immigrants respond in multiple ways, including shaping their identities to highlight their image as hard workers and to distance themselves from images of immigrants as criminals. These two forces shape immigrants’ views about themselves and of their position in U.S. society.
The consequences of immigration for the welfare states has received increased attention by scholars and in political and media debates in Europe. However, migrants’ subjective understandings of the welfare state remains an understudied research topic. This study aims to address the topic by analysing the question in the Nordic context by looking at Estonian labour migrants’ understandings of the Finnish welfare state. Our data consists of 51 biographical interviews with Estonian migrants in Finland. Based on the interviews, we traced interviewees’ attitudes towards the Finnish welfare state. In Finland, Estonians aspire for social citizenship, which in their case refers to gaining economic welfare and embracing Finnish welfare state institutions. This aspiration for social citizenship is revealed in Estonians’ ‘identity talk’, which takes two forms: embracement and distancing. By embracement, we mean their positive sentiments towards the institutions and norms of the Finnish welfare state. The interviewees highlight their participation in the labour market, diligent payment of taxes, justified use of the welfare benefits and services offered by the Finnish state, and membership in trade unions and unemployment funds. The interviewees underline the link between work and the deservingness of welfare benefits. They describe themselves as deserving, which, they claim, should put them on par with native Finns. Moreover, by means of distancing, the interviewed Estonians distinguish themselves from ‘others’—in their opinion—‘non-deserving’ migrants who ‘do not contribute’ to the Finnish welfare state.
Claims for improving migrants’ access to care often draw on universalistic ethical notions, such as the principle of equity as it is specified in human rights law and public health ethics. These claims contrast with political realities across most welfare states. In the underlying public discourses, the frontline arguments against greater inclusion have often focused on practical concerns, such as the costs of healthcare provision. Yet it has also been suggested that ultimately context‐specific moral frameworks play a key role in demarcating legitimate right‐holders from undeserving others. Hence, is this a conflict between ethical principles and practical concerns? Or between different ethical perspectives? And why would that question matter? We propose that awareness of the nature of the arguments involved and respect for different ethical views are critical for coherent and constructive debates. This paper looks at the ways in which ethical concepts are used to justify exclusionary policy decisions. In particular, it examines the rationales that inform health policies towards documented and undocumented labor migrants in two welfare states, Germany and Israel, through the qualitative analysis of policy documents and 71 in‐depth interviews. The study points to the central role of particular concepts of health‐related deservingness. These results lead to the proposition that the fundamental clash in the discussion on migrants’ access to care is one, albeit not solely, between contrasting ethical perspectives. Drawing on process‐oriented approaches to ethical decision‐making, the paper concludes with three suggestions for moving forward with the migrant health rights debate.
It is often maintained that contemporary foreign labour recruitment programs have taken an increasingly selective stance and that skills are increasingly crucial in granting migrants easier access and stronger welfare and residency rights in receiving countries. The paper provides a retrospective account of the evolution of Italian labour migration management, paying attention to the changing selection criteria reflected in some of its “front, back and side doors”. It will be shown that Italian labour migration management is increasingly embracing a bifurcated regime of deservingness. Despite some recent tentative signs of change towards an increased evaluation of high skills as a selection principle embedded into a competitiveness‐driven frame, over the last decades labour migration management has been largely dominated by the recruitment of a low‐skilled workforce. The paper discusses the emergence of a specific construction migrants’ deservingness placing Italy in a peculiar position in a European context.